| Daisy G. Ison, D.m.d., Inc. | |
|
5345 N El Dorado St Suite 2 Stockton CA 95207-5872 | |
| (209) 952-2933 | |
| (209) 952-2271 |
| Full Name | Daisy G. Ison, D.m.d., Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 5345 N El Dorado St, Stockton, California |
| Authorized Official Name and Position | Daisy Gonzaga Ison (DENTIST) |
| Authorized Official Contact | 2099522933 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Daisy G. Ison, D.m.d., Inc. 5345 N El Dorado St Suite Stockton CA 95207-5872 Ph: (209) 952-2933 | Daisy G. Ison, D.m.d., Inc. 5345 N El Dorado St Suite 2 Stockton CA 95207-5872 Ph: (209) 952-2933 |
| NPI Number | 1093865610 |
|---|---|
| Provider Enumeration Date | 01/12/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093865610 | NPI | - | NPPES |
| 1615122 | Other | PA | UNITED CONCORDIA |
| 542-42856 | Other | AL | BLUE CROSS |
| B34120-02 | Other | CA | DELTA DENTAL |
| 1B0K9G | Other | MA | BLUE CROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 34120 (California) | Primary |
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